On Anthony Weiner, Personality Disorders and 3rd Chances

 On Anthony Weiner, Personality Disorders and 3rd ChancesOne of the things I love about NYC is that everybody here gets a second chance as long as you earn it by coming clean, getting help, doing some kind of penance and working hard.  I want to thank my adopted city for that because everyone deserves salvation. With this in mind, since Anthony Weiner decided to run for mayor of NYC, I’ve defended him to friends and snarky talk show hosts who hate anyone progressive.  But today, after learning that Weiner (a/k/a ‘Carlos Danger’ – really??) kept right on sexting with a young female ‘fan’ long after he resigned from Congress for the same reason, I’ve revised my opinion and my diagnosis is in.

Warning:  I’m neither a clinician nor certified in any way to use the DSM-V.  I’m not in any priesthood, in fact.  I’m just a clear-eyed woman who sees what she sees and is willing to name it.  And I vote.

In April I went to the best one day seminar I’ve ever attended by a superb presenter named Dr. Greg Lester.  The topic was personality disorders (PD) and Lester is one of the nation’s experts on this topic.  The audience was composed of clinicians (except for me). Lester is a psychologist with 30 years experience working exclusively with personality disordered clients.  He travels the world to share state of the art information with clinicians about this most difficult of populations and he has two active practices in CO and TX.  Oddly, or ironically depending on your point of view, he’s a dead ringer for Hugh Laurie who plays the lead role of the narcissistic MD in “House”.   In fact, Lester could be House.  The similarity is spooky.

Here’s the executive summary and it stunned this audience.  Contrary to earlier understanding of PD populations, new technologies such as fMRIs and PET scans that evaluate live brains have determined that

PDs are in fact 100% biological or genetic.

PDs show up in 15-20% of every population all over the globe, regardless of condition (gender, race, socio-economics, childhood upbringing, etc).  They are not created by trauma or abuse. They are either inherited or are the result of physical brain development.

Unlike mental illness where there is a malfunction of something that can be corrected with medication, as in schizophrenia or psychosis, (akin to diabetes being a malfunction of the pancreas which is then treated with insulin), PDs are the result of something missing – neurons are missing – and so medication does not work for them.  Depending on where neurons are missing, the person will present as one of the 10 categories of PDs.  Missing neurons means gaps in synapses.  ZZZZT.   ZZZZT.  The information doesn’t flow right and creates the classic behavioral patterns we associate with PDs. So we actually have a whole population of “incomplete people”, as Lester calls them, who do not have the ability to self-correct because they have missing parts.

Back to Weiner.  This most recent news about him has revealed him to me to be a narcissist,

one of the best known personality disorders.  Lester reminded us that since narcissists know that something is wrong with them that they can’t fix, they feel that they are ‘bad people’ inside, and to survive they create a ‘grandiose image’ that must be protected at all costs.  Threaten that image and a narcissist will destroy you.  Lester said that narcissists are over-represented in occupations that are ‘image centered’: politics, professional sports, media, the military and CEOs of all stripes.   (Quick…name 25 in the next minute…GO. This won’t take long..)

How do you recognize a narcissist?  Most often, they are very charismatic because they need to draw others in.  They will make you feel so special, like you are the only one in the world.  Then when you get caught in the seduction, they’ll begin to criticize you and make you feel like you are less-than in order to feel like they are better than you.  They soon become perpetrators to your victim, blaming every bad thing in their lives on you and others. They can be wildly impulsive and deeply cold.  They rarely seek help because they can’t risk the exposure of their image.  In fact, Lester says that this is the only PD that commits suicide without depression.

In other words, they’ll die to protect their image.

Weiner didn’t learn that what he did was wrong/intimidating/stupid/etc.  He still needs constant validation that he’s the BEST.  Despite the humiliation of losing his brilliant career in such a public way, despite the support of his beautiful wife and the birth of his son, Anthony Weiner is still compelled to have fantasy sex on line with a stranger.  It is mystifying if you don’t understand PDs.

Because people with PDs don’t learn very well.  They’re missing critical pieces of their brains.

Weiner doesn’t get that NY was poised to give him a second chance because he’s smart and tough enough to lead this complicated and demanding city, but now he’s blown it.  No more chances because the man is out of control and cannot be trusted.  In fact, he’s blackmail material.  Yes, NY Magazine got it right.  Time for Anthony to get into treatment because Dr. Lester says that it is possible to cure PDs but it isn’t easy.  The clinician has to “install and upload new software”, meaning a new behavioral pattern, in order to create new neural pathways to re-route around the synaptic gaps.  He says it takes several years of weekly work to “cure” a narcissist and only if that person is willing and committed.

NYC travels at the speed of light.  We have no time for this man to get fixed.

And so this is the tragedy of people with PDs.  They destroy lives and themselves in the end.

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